The term shin splints is a general term used to describe a number of conditions causing pain in the anterior aspect of the leg, also known as the shin. Medically, the term shin splints is often known as Medial Tibial Stress Syndrome (MTSS). Shin splints is a very common complaint, especially in the athletic population. It is most commonly seen in runners but can affect any athletes that play sports that require a lot of running and jumping, for example, football, basketball and soccer.
Common Symptoms of Shin Splints
As the term shin splints refers to a large number of conditions, symptoms can vary significantly. The presence of pain however is a common symptom in most, if not all pathologies causing shin splints type shin pain. Some of the more common symptoms seen include:
- Pain in the front of the shin, along the shin bone (Tibia) commonly, occurring anywhere from the knee to the ankle
- Pain often worsens with exercise, however, in some cases pain is improved with exercise
- Pain sometimes only presents after vigorous exercise and not during the activity
- The area is tender and sore to touch
- The overlying skin may be red and inflamed, however, in many cases the skin appears normal
The symptoms of shin splints are wide and in many cases contradictory. This emphasises the fact that shin splints is only a broad heading under which many conditions lie. The above symptoms however are what is most commonly described in typical shin splints complaints.
What Causes Shin Splints?
There has been and still is much debate and research underway into the exact causes of shin splints. Many theories have been put forward, ranging from bone disorders to muscle and tendon disorders as well as blood and nerve related pathologies. Depending on the specific diagnosis the causes may differ, however, more commonly identified factors in the typical presentation of shin splints include:
- Overuse: exercising too often, exercising above ones capabilities, decreased rest time between activity or a sudden increase in activity compared to normal levels are some factors that can result in the development of shin splints.
- Poor biomechanical alignment: this includes lower limb muscle weaknesses, tightness or imbalances, excessively flat-feet or conversely high-arched feet and also ligament laxity.
- Footwear: poor footwear, or footwear not complementary to the individual’s foot type, is a major factor in the development of shin splints. Wearing the wrong type of shoe or wearing excessively worn shoes is often the instigating factor in the development of symptoms.
- Surfaces: activity, especially running and jumping, on hard and/or uneven surfaces, especially on a regular and high intensity basis can result in the development of shin splints. This is often overlooked as a contributing factor but is very vital factor that needs to be addressed when treating shin splints.
Some specific pathologies that cause shin splint type symptoms, and that may be caused by a number of different factors, include:
- Stress fractures to the Tibia (shin bone)
- Tendinitis of lower leg muscles (primarily the tibialis anterior muscle tendon)
- Compartment syndrome
How are Shin Splints Diagnosed?
As mentioned, shin splints is a broad name given to a number of conditions that cause pain in the front of the leg i.e. the shin. Therefore, as there are a number of potential diagnoses, the main method of diagnosing shin splints is clinically. In other words using the patient’s history and a focused clinical exam to make a diagnosis. When the diagnosis is unclear, or when a particular pathology is suspected, diagnostic tools such as x-rays, bone scans and MRI’s can be ordered, however, this is usually not required.
Shin Splints Treatment
Depending on what the specific diagnosis is causing the shin pain and depending on its causative factors, treatment will vary. Some common and widely used treatments for specifically diagnosed shin pathologies as well as for non-specific general shin pain include:
- Rest or activity modification
- Icing of the painful area
- Compression and elevation if there is swelling in the area
- Pain management medication
- Footwear change
- Foot orthoses, both custom made and off the shelf devices
- Strapping of the foot and/or shin
- Muscle stretches for tight musculature and to increase flexibility
- Muscle strengthening to correct imbalances
- A gradual return to activity
Shin Splints Prevention For Bodybuilders
A number of measures can be put in place to help reduce and improve the symptoms of shin splints or in some cases to completely eradicate them. These include:
- Undertaking adequate warm-up and warm down, including adequate stretching of lower limb muscles
- Strengthening the muscles in your legs
- Choosing even, flat, softer surfaces to run/play sports on
- Reduce the intensity or time of activity
- Increase rest between exercise sessions
- Purchasing proper athletic sneakers to support your foot
When to Seek Medical Attention For Shin Splints
Shin pain is a very common complaint amongst athletes, whether they are at the amateur or elite level. While many cases of shin pain spontaneously resolve with rest, in some cases this does not always occur. Medical attention should be sought if pain levels are not improving despite resting and other treatments or if pain levels are worsening. If the area becomes especially tender to touch. If there is any deformity present. Lastly, if there is pain experienced during night time or that wakes you from your sleep.
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